ABSTRACT
Introduction Sperm DNA integrity is a crucial paternal factor affecting fertilization and pregnancy rates, as well as embryo development. Case The present case report describes the successful pregnancy after testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI) (TESA-ICSI) in a couple where the male presented high sperm DNA fragmentation. In order to sort damaged sperm presenting DNA fragmentation, magnetic activated cell sorting (MACS) with annexin V microbeads (MACS Miltenyi Biotec, Teterow, Germany) was used. Conclusion The authors present the first description of a successful medical case using TESA-ICSI annexin V sperm sorting. Additionally, a follow-up of the child at the age of 4 years old was done.
ABSTRACT
INTRODUCTION: In ICSI and conventional IVF cycles, the embryos are usually selected for transfer based on evaluation of the cleavage speed and the extent of blastomere fragmentation. Pronuclear stage scoring system has been used in IVF recently as an additional parameter. OBJECTIVES: The aim of this study was to classify embryos from ICSI cycles according to the pronuclear scoring system and its influence on implantation rate. MATERIAL AND METHODS: 62 couples suffering from different types of infertility and treated by ICSI were included in our study. For each embryo, the following data were analyzed: pronuclei (PN) morphology, 16-20 hours after ICSI, and embryo morphology, about 40-42 (day 2) and 65-68 (day 3) hours after ICSI. The embryo transfer was performed on the third day after pick-up. RESULTS: In 55 (88.7%) cases we transferred at least one embryo from the zygotes of 0 or 1 or 2 pattern. The implantation rate was 30.6% (n = 19). In all of these cases the embryos have been derived from zygotes from pattern 0, 1 or 2. CONCLUSIONS: Pronuclear scoring system of zygotes appears to be a predictor of the implantation potential. Embryos derived from pattern 0, 1 and 2 of zygotes implant at a higher rate (p = 0.05).
Subject(s)
Blastocyst/physiology , Embryo, Mammalian/physiology , Embryo, Mammalian/ultrastructure , Zygote Intrafallopian Transfer , Zygote/physiology , Zygote/ultrastructure , Adult , Blastocyst/ultrastructure , Cell Nucleus/ultrastructure , Cleavage Stage, Ovum , Embryo Implantation , Embryo Transfer , Female , Humans , Infertility/therapy , Male , Predictive Value of Tests , Pregnancy , Retrospective Studies , Sperm Injections, Intracytoplasmic/methods , Zygote Intrafallopian Transfer/methodsABSTRACT
Anti-Müllerian hormone (AMH) measurements are widely used to optimize the stimulation protocols. First generation AMH kits correlated well with ovarian reserve and response to stimulation. In the present study we aimed to asses if the new generation kits share the same accurate correlations. Retrospective data were collected from 8323 blood samples. For comparison we used Immunotech I generation kit (ImI 4035 samples), Beckman Coulter II generation kit RUO (BCII RUO 3449, samples) and Beckman Coulter II generation kit with IVD certificate (BCII IVD 839 samples). We compared average AMH concentrations measured with different kits, as well as correlation between kits. We also compared average AMH concentrations in sera collected on different cycle days and samples of different quality of preservation. AMH serum concentrations differed for each kit, ranging 4.4 ± 4.12 (mean ± SD) for the ImI, 2.68 ± 3.15 for the BCII RUO, and 1.64 ± 2.85 for BCII IVD. The mean differences from an adjusted regression model were -48.7%, -40%, and -69.2%, respectively. In conclusion, the changes of the BC AMH kits are unpredictable; however, the improvement of them is still possible. It would be very dangerous to use elaborated stimulation protocol (based on the Ist generation AMH results) with the results from the IInd generation assays.